Peds Respiratory Flashcards
What is the most common Respiratory Disease seen in Children?
Acute Respiratory Infections
Are Acute Respiratory Infections Viral or Bacterial?
They can be either
Do Acute Respiratory Infections impact the Upper or Lower Respiratory System?
They can impact either
Where does the Upper Airway end and the Lower Airway start?
The Upper Airway ends above the Trachea, the Trachea and everything below it is the Lower Airway
How are Acute Respiratory Infections spread?
Infected Particles (Bacterial, Viral, Fungi) spread via Contact and Droplets
What do Acute Respiratory Infections do to the Airway?
Cause Inflammation of Airway Tissues, Nasal Drainage, and Congestion
What is the Incubation Period for an Acute Respiratory Infection?
1-3 Days, then Sudden Onset of Symptoms
How long does an Acute Respiratory Infection last for?
4 - 10 Days
What is the most common Acute Respiratory Infection?
Upper Respiratory Infections (URI’s)
What age group has the highest incidence rate of URI’s?
Kids under 5 YO
What are Acute Respiratory Infections most often caused by?
Viruses
When are Acute Respiratory Infections most often going to occur?
Winter and Spring
Is Prenatal History a very significant thing to consider in terms of Acute Respiratory Infection in children?
Yes
Why are children so at risk for Acute Respiratory Infection?
They’ve got an Immature Immune System + They share germs more readily
Between Children and Adults who’ve got an Acute Respiratory Infection, who is more symptomatic?
Children
Are the manifestations of Acute Respiratory Infection severe or minimal in terms of invasiveness?
They vary from Minimal to Severe
What are the Minimal symptoms of an Acute Respiratory Infection?
Sneezing + Coughing + Eye Drainage + Fatigue + Headache + Low Grade Fever
What are the More Serious symptoms of an Acute Respiratory Infection?
Tachypnea + Labored Breathing + Wheezing / Other Unexpected Sounds + Hypoxia (with/without Hypercapnia) + Retractions + Nasal Flaring + Changes in LOC (Can progress into a Minimally Responsive State)
What is the best way to diagnose a mild Acute Respiratory Infection?
Physical Assessment
Will a mild Acute Respiratory Infection require any kind of diagnostic testing?
No, just the Physical Assessment
What diagnostic tests may be done to diagnose an Acute Respiratory Infection?
Rapid, Simple Testing (Swabs for Throat Infections, Influenza A and B, Respiratory Syncytial Virus (RSV), or Covid 19 tests may be completed)
CXR (Chest X-Ray) and CBC Count with diff may be needed.
Can vaccines prevent any Acute Respiratory Infections?
Yes
What is Croup?
Upper & Middle Airway Edema that results in restricted airflow
What might Croup be caused by?
Allergens (Spasmodic) + Viruses (Viral) + Bacterial
How long is the duration of Croup Cough? Can it be an Emergency?
Short Duration, Self-Limiting, typically Non-Emergent
What is the main symptom of Croup?
A Barky Cough
When do the manifestations of Croup typically occur?
At Night
What Virus typically causes Viral Croup?
para-influenza
What are the symptoms of Viral Croup?
Respiratory Illness with Fever + Inflammation + Typically doesn’t repeat
What are the symptoms of Spasmodic Croup?
No Fever + Edema + Reoccurring + Manifestations most often occur at Night
Who are the people most at risk of Croup?
Kids aged 3 Months - 3 Yo.
People with a Family History OR a reported history of Nasal Drainage.
When does Croup most often occur?
Autumn + Early Winter
What are the manifestations of Croup during the first 2 days?
Nasal Congestion + Nasal Discharge
What is the other name for Nasal Discharge & Congestion?
Coryza
What are the manifestations of Croup during day 3?
Fever + Barky Cough + Hoarseness
What are the manifestations of Croup after day 3?
Edema of the Airway + Tachypnea & Prolonged Inspiratory Phase.
Respiratory Distress is possible if left untreated.
Anxiety / Agitation may occur before or after day 3.
What is crucial in preventing the symptom escalation of Croup?
Early Intervention
How is Croup diagnosed?
Can be diagnosed via Physical Assessment.
May need an X-Ray to assess Soft Tissue Edema.
WBC Count may be needed to rule out other infectious diseases.
How is Croup treated?
Nebulized Meds + PO / INJ Steroids
Mechanical Ventilation (if Severe)
In what ages is Croup often seen?
Croup only occurs during Childhood
What does it mean if Croup is Self-Limiting?
It can often improve on it’s own without medical treatment
Should Antibiotics ever be administered for Coup?
Nah
Whenever inflammation occurs, what can happen with the Epiglottis?
It can completely cover the Trachea & cause Respiratory Failure
What is an Inflamed Epiglottis called?
Epiglottitis
What can Epiglottitis lead to if not immediately treated?
Cardiopulmonary Arrest
What can Infectious Epiglottitis be caused by?
Infectious Particles that enter through the Nasopharyngeal Passages
Most Common:
Haemophilus Influenzae Type B (Hib)
What age group is at the highest risk for Epiglottitis?
Children under 5 YO that are Unvaccinated against Hib
Is Epiglottitis infectious or non-infectious?
Can be either
What are some Non-Infectious causes of Epiglottitis?
Trauma:
Burns + Inhalation of Smoke / Chemicals / Heat
Epiglottitis is usually not a medical emergency.
True or false?
False
What’s the most common symptom of Epiglottitis?
Drooling
What position do pt’s with Epiglottitis prefer to be in?
Orthopnea Position (Tripod Position)
What is Bronchitis?
The Lining of the Bronchi become Edematous
If Bronchitis occurs, what will the Bronchi do?
Produce Mucous (Causing a Coughing response)
What are some causes of Bronchitis?
Influenza + Covid + RSV
How is Bronchitis mainly treated?
With Hydration
What are the risk factors of Bronchitis?
<2 YO + Premature Birth + Low Birth Weight + Underlying Lung Disease / Heart Condition + Immunocompromised
What are the symptoms of Bronchitis?
Cough + Fever + Tachycardia + Wheezing & Crackles + History of Urinary Tract Infection + Labored Breathing + Hypoxia + Retractions
Aside from Hydration, what are other things that can be done to treat Bronchitis?
Fever Management + Nasal Drops + Nasal Suctioning
What do pt’s with Bronchitis need to be taught about?
How to recognize worsening symptoms + How to manage their symptoms
What is Bronchiolitis?
Inflammation at the end of the Bronchioles
What happens to your Epithelial Cells whenever you’ve got Bronchiolitis? What symptoms does this cause?
They become damaged and slough.
This results in Edema + Blocked Airway + Atelectasis + Excessive Mucous Production.
What is Bronchiolitis typically caused by?
RSV
In what age group is Bronchiolitis most common?
Children younger than 2 YO
At what seasons does Bronchiolitis usually occur the most?
Autumn + Winter
What does RSV stand for?
Respiratory Syncytial Virus
How is RSV spread? What precautions should a pt with RSV be put on?
Spreads via direct contact via Nasal / Eye Mucous Membranes.
Droplet Precautions.
How long does RSV last on surfaces?
For Hours
How long is the Incubation Period for RSV?
4-6 Days
How long does it take for RSV to go away once you get sick with it?
11 Days
What seasons does RSV typically occur?
Fall to Early Spring
In what age group does RSV affect? How does age impact the manifestations of RSV?
Seen in All Ages + Manifestations Lessen with Age
What are the risk factors of RSV?
Infants younger than 6 Months Old + Premature Births + Born during Autumn or Winter + Low Birth Weight.
Down Syndrome + Underlying Heart / Lung Condition + Immunocompromised + Attend Daycare or have Older Siblings + Second Hand Smoke + Low Socioeconomic Status.
What are the symptoms of RSV?
They Vary.
Lower Respiratory Tract Infections + Restricted Airflow, Increased Mucous Production, and Stasis + Wheezing / Crackles + Altered RR and Pattern + Bronchospasms that result in Severe Coughing + Tachycardia + Hypoxia
How is RSV treated?
Hydration + Fever Management + Nasal Drops + Nasal Suctioning
How is RSV treated/prevented Pharmacologically?
Palivizumab
Nirsemivab
Maternal Vaccine during Pregnancy
How is RSV diagnosed?
Gold-Standard = Nasal Secretion Sample Test - Nasal Washing.
Others:
Nasal Swab (Can also test for other viruses).
The Polymerase Chain Reaction (PCR) Test.
(Most Preferred to confirm RSV).
What is important to consider with Pediatric pt’s with RSV?
Smaller Airway = More Severe Symptoms
What accounts for 1/3 of all Pharyngeal Infections?
Streptococcal Pharyngitis (Strep Throat)
What bacteria causes Streptococcal Pharyngitis?
Group A Strep (GSA)
What is occurring with a pt who has Strep Throat?
GSA enters through the Nasal Passages and attacks/invades the Epithelial Mucosal Lining of the Pharynx
What are the risk factors for Strep Throat?
Pre-School & School-Age Kids
Winter & Spring Months
What are the symptoms of Strep Throat?
Sore Throat without Nasal Drainage and Fever.
Red Throat + Petechiae (White Patchy Exudate on the Pharynx).
Red Tongue that looks like a Strawberry.
Rough, Red, Sandpaper-Like Rash on the Trunk of the Body (Scarlatina Rash).
If a pt has Cervical Lymphadenopathy (Swollen Lymph Nodes of the Neck), which one is more likely?
Bacterial Strep Throat or Viral Strep Throat?
Bacterial Strep Throat
How can Strep Throat be diagnosed?
Swab for GAS Bacteria.
If the pt has a negative GAS test but Strep Throat is still suspected, perform a Blood Culture to prevent a Misdiagnosis.
How is Strep Throat treated?
Appropriate Antibiotics (Typically, PO is prescribed).
If the pt is non-compliant, administer a 1-Time IM injection of Penicillin.
How will Antibiotics need to be dosed for a pt with Strep Throat?
Dose depends on the pt’s Age + Weight
A pt with Strep is taking Antibiotics, should they keep taking them even after they feel better?
Yes
